CCA Practice Exam 1 || Most Recent Exam 2026 Actual
Complete Real Exam Questions And Correct Answers (Verified
Answers) Already Graded A+ | Newest Exam | Just Released!!
What is the best reference tool for ICD-10-CM/PCS coding
advice?
a. CMS Inpatient Prospective Payment System (IPPS)
b. CMS ICD-10-CM and ICD-10-PCS Coding Guidelines
c. AHA's Coding Clinic for ICD-10-CM/PCS
d. National Correct Coding Initiative (NCCI) - ANSWER-41. c
AHA's Coding Clinic for ICD-10-CM/PCS is a quarterly
publication of the Central Office on ICD-10-CM/PCS, which
allows coders to submit a request for coding advice through
the coding publication. AHA Coding Clinic is the only official
publication for ICD-10-CM/PCS coding guidelines and advice
provided by the four
Cooperating Parties
CMS developed medically unlikely edits (MUEs) to prevent
providers from billing units of services greater than the norm
would indicate. These MUEs were implemented on January 1,
2007, and are applied to which code set? a. Diagnosis-related
groups
b. HCPCS/CPT codes
c. ICD-10-CM/PCS diagnosis and procedure codes
,d. Resource utilization groups - ANSWER-42. b CMS developed
MUEs to prevent providers from billing units in excess and
receiving inappropriate payments. This new editing was the
result of the outpatient prospective payment system that
pays providers passed on the HCPCS/CPT code and units.
Payment is directly related to units for specified HCPCS/CPT
codes assigned to an ambulatory payment classification
Several key principles require appropriate physician
documentation to secure payment from the insurer. Which
answer (listed here) fails to impact payment based on physician
responsibility?
a. The health record should be complete and legible.
b. The rationale for ordering diagnostic and other ancillary
services should be documented or easily inferred.
c. Documenting the charges and services on the itemized bill.
d. The patient's progress and response to treatment and any
revision in the treatment plan and diagnoses should be
documented. - ANSWER-43. c The documentation of the
charges and itemized bill is not the responsibility of the
physician
The documentation of each patient encounter should include
the following to secure payment from the insurer except
________.
a. The reason for the encounter and the patient's relevant
history, physical examination, and prior diagnostic test
results
b. A patient assessment, clinical impression, or diagnosis
,c. A plan of care
d. The identity of the patient's nearest relative and emergency
contact number - ANSWER-44. d The identity of the patient's
nearest relative and an emergency contact number are not
relative to securing payment from the insurer. The encounter
should include the date of the encounter and the identity of
the observer
Two Medicare patients were hospitalized with bacterial
pneumonia. One patient was hospitalized for three days, and
the other patient was hospitalized for 30 days. Both cases
result in the same MS-DRG with different lengths of stay. Which
answer most closely describes how the hospital will be
reimbursed? a. The hospital will receive the same MS-DRG for
both patients but additional reimbursement will be allowed for
the patient who stayed 30 days because the length of stay was
greater than the geometric length of stay for this MS-DRG. b.
The hospital will receive the same reimbursement for the same
MS-DRG regardless of the length of stay.
c. The hospital can appeal the payment for the patient who
was in the hospital for 30 days because the cost of care was
significantly higher than the average length of stay for the MS-
DRG payment.
d. The hospital will receive a day outlier for the patient who
was hospitalized for 3 - ANSWER-45. b The hospital will receive
the same reimbursement regardless of the length of stay
Which one of the following statements is true?
a. The higher the relative weight, the higher the payment rates.
, b. The lower the relative weight, the higher the payment rates.
c. The lower the relative weight, the sicker the patient.
d. The higher the relative weight, the lesser reimbursement
due the facility -
ANSWER-46. a Higher relative weights link to higher
payment rates
Which classification system is in place to reimburse home
health agencies?
a. MS-DRGs
b. RUGs
c. HHRGs
d. APCs - ANSWER-47. c Home health resource groups
(HHRGs) represent the classification system established for
the prospective reimbursement of covered home care
services to Medicare beneficiaries during a 60-day episode of
care
On October 1, 2012, the Affordable Care Act established the
________ which requires CMS to reduce payments to IPPS
hospitals with excess admissions.
a. Hospital-acquired conditions (HACs)
b. MS-DRGs
c. Hospital Readmissions Reduction Program
d. RUG-III - ANSWER-48. c One section of the ACA established
the Hospital Readmissions Reduction Program, requiring
CMS to reduce payments to the IPPS hospitals for discharges
beginning October 1, 2012
Complete Real Exam Questions And Correct Answers (Verified
Answers) Already Graded A+ | Newest Exam | Just Released!!
What is the best reference tool for ICD-10-CM/PCS coding
advice?
a. CMS Inpatient Prospective Payment System (IPPS)
b. CMS ICD-10-CM and ICD-10-PCS Coding Guidelines
c. AHA's Coding Clinic for ICD-10-CM/PCS
d. National Correct Coding Initiative (NCCI) - ANSWER-41. c
AHA's Coding Clinic for ICD-10-CM/PCS is a quarterly
publication of the Central Office on ICD-10-CM/PCS, which
allows coders to submit a request for coding advice through
the coding publication. AHA Coding Clinic is the only official
publication for ICD-10-CM/PCS coding guidelines and advice
provided by the four
Cooperating Parties
CMS developed medically unlikely edits (MUEs) to prevent
providers from billing units of services greater than the norm
would indicate. These MUEs were implemented on January 1,
2007, and are applied to which code set? a. Diagnosis-related
groups
b. HCPCS/CPT codes
c. ICD-10-CM/PCS diagnosis and procedure codes
,d. Resource utilization groups - ANSWER-42. b CMS developed
MUEs to prevent providers from billing units in excess and
receiving inappropriate payments. This new editing was the
result of the outpatient prospective payment system that
pays providers passed on the HCPCS/CPT code and units.
Payment is directly related to units for specified HCPCS/CPT
codes assigned to an ambulatory payment classification
Several key principles require appropriate physician
documentation to secure payment from the insurer. Which
answer (listed here) fails to impact payment based on physician
responsibility?
a. The health record should be complete and legible.
b. The rationale for ordering diagnostic and other ancillary
services should be documented or easily inferred.
c. Documenting the charges and services on the itemized bill.
d. The patient's progress and response to treatment and any
revision in the treatment plan and diagnoses should be
documented. - ANSWER-43. c The documentation of the
charges and itemized bill is not the responsibility of the
physician
The documentation of each patient encounter should include
the following to secure payment from the insurer except
________.
a. The reason for the encounter and the patient's relevant
history, physical examination, and prior diagnostic test
results
b. A patient assessment, clinical impression, or diagnosis
,c. A plan of care
d. The identity of the patient's nearest relative and emergency
contact number - ANSWER-44. d The identity of the patient's
nearest relative and an emergency contact number are not
relative to securing payment from the insurer. The encounter
should include the date of the encounter and the identity of
the observer
Two Medicare patients were hospitalized with bacterial
pneumonia. One patient was hospitalized for three days, and
the other patient was hospitalized for 30 days. Both cases
result in the same MS-DRG with different lengths of stay. Which
answer most closely describes how the hospital will be
reimbursed? a. The hospital will receive the same MS-DRG for
both patients but additional reimbursement will be allowed for
the patient who stayed 30 days because the length of stay was
greater than the geometric length of stay for this MS-DRG. b.
The hospital will receive the same reimbursement for the same
MS-DRG regardless of the length of stay.
c. The hospital can appeal the payment for the patient who
was in the hospital for 30 days because the cost of care was
significantly higher than the average length of stay for the MS-
DRG payment.
d. The hospital will receive a day outlier for the patient who
was hospitalized for 3 - ANSWER-45. b The hospital will receive
the same reimbursement regardless of the length of stay
Which one of the following statements is true?
a. The higher the relative weight, the higher the payment rates.
, b. The lower the relative weight, the higher the payment rates.
c. The lower the relative weight, the sicker the patient.
d. The higher the relative weight, the lesser reimbursement
due the facility -
ANSWER-46. a Higher relative weights link to higher
payment rates
Which classification system is in place to reimburse home
health agencies?
a. MS-DRGs
b. RUGs
c. HHRGs
d. APCs - ANSWER-47. c Home health resource groups
(HHRGs) represent the classification system established for
the prospective reimbursement of covered home care
services to Medicare beneficiaries during a 60-day episode of
care
On October 1, 2012, the Affordable Care Act established the
________ which requires CMS to reduce payments to IPPS
hospitals with excess admissions.
a. Hospital-acquired conditions (HACs)
b. MS-DRGs
c. Hospital Readmissions Reduction Program
d. RUG-III - ANSWER-48. c One section of the ACA established
the Hospital Readmissions Reduction Program, requiring
CMS to reduce payments to the IPPS hospitals for discharges
beginning October 1, 2012
